I'm afraid Max's allergies are getting the better of him.
Symptom 1:
Licking/nipping/pulling hair from between toes underneath the paw (not on top of foot). Started around Nov/Dec. Initially caused moderate inflamation on several of his paws. Now, normal-mild pinkness on his 4 paws. Mostly on side towards body.
Possible: his diet changed to chicken low fat in Aug/Sept.
Hunch: maybe he does not like the smell of ground on feet? Vet suggested hydrogen peroxide shampoo on feet daily.
Symptom 2:
Chronic smell/inflamation/excessive wax in left ear. Started Dec. Cyclical cleaning has helped. Vet just put in extended 2ml liquid which has aleviated inflamation.
Possible: Food related.
Symptom 3:
Nipping at top of shin, forearm, thigh. Brief periods. Was present up to last summer. Disappeared. Reappeared 4 days ago. Itchiness will wake him from rest to nip then go back to sleep. Fleas not visible to naked eye.
Possible: environmental?
His eyes are clear and there is no bum-scooting behaviour. He does scratch at his chin periodically.
Any ideas?
Dr. Marie replied:
Ah, poor Max. It does sound like he is having issues with allergies still.
It sounds like you are doing the right things. I will give you some of my thoughts on things that have helped other patients I have who have allergy symptoms like this.
It is good that you have Max on special food. I have started to really recommend a food called Skin Support. It is good for food allergies but also helps somewhat with environmental allergies as well.
I can't remember if Max is on steroids at all. I do find that most of my allergy patients need a small dose of steroids in order to stay comfortable and not itchy.
I'm guessing that the nipping at himself is likely due to allergies as well. It's not a bad idea to talk to your vet about starting his flea prevention a little early this year just in case.
I wish I had a magical quick solution for you. Allergies can be tough. There are a great number of things that can be done. The goal is to do what needs to be done so that he is not uncomfortable.
I hope things don't get worse!
Dr. Marie.
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Customer reply:
Last May-July he was on Skin Support to see if that would alleviate the nipping. It did not. The fact it disappeared August-March makes it sound like an environmental allergy but the tops of legs and arms aren't a usual spot.
I'm willing to try medical Hypo (duck) if it will help, he's currently on the medical GI low fat.
He's not on any meds at all right now. I don't like the idea of steroids but..
Last year he was on Advantage all summer, didn't make a difference.
A concern is that its only March and his allegies have begun. I know that environmental allergies tend to get worse and worse year after year. That concerns me.
Dr. Marie replied:
I think your vet will likely be supportive of changing to a hypo food. If you do so, it's important to stick to just this food. For the first couple of months that he is on it he can't eat any other treats or food. Then, if he is doing well on it you can gradually reintroduce foods one at a time.
I can't say that I have seen an increase in allergies yet, but I am guessing that with this crazy warm weather I will see more dogs in earlier this year.
Not all dogs get worse with their allergies every year. Some have good years and bad years. I had a lot of clients whose dogs did better last year than usual. It seems like some years produce more allergen (i.e. pollen, etc) than others. So, just because he's starting up in March, it doesn't mean that he is destined to get worse!
Customer reply:
the vet explained that with increasing exposure comes an increased response, year after year.
How common are allergies in dogs?
Dr. Marie replied:
Allergies are very very common in dogs. There are some days in the year where I will see twice as many dogs for allergies as I do for routine vaccines.
Customer reply:
The vet has recommended Medical Hypo, which I will follow through on if only because it may alleviate the ear/chin itchiness. (would it make sense to try an opposite food, like lamb/rice or does this delay the process?)
The nipping has to be a seasonal thing somehow. I wish I knew.
The licking/biting pads... it may sound crazy but it might be just a dog who dislikes dirty feet.
I've been extremely fortunate in that at this point there is no physical damage.
I will keep you posted.
Thank you.
Jay
Dr. Marie replied:
I use a lot of Medical Hypo (soon to be renamed Royal Canin Hypo by the way) in my practice. This sounds like a good plan.
I have seen a few dogs that lick their feet out of habit, or like you mentioned, to keep them clean. If the licking is obsessive (i.e. if there is brown saliva staining on the feet or if the feet are red because of the licking) then it's likely more related to allergies than to cleanliness.
Let's hope that things don't get any worse!
Customer reply:
Actually....underneath between toes appears pinkish instead of white, but no evidence of licking at all.
vet suggested perhaps a peroxide shampoo daily.
Dr. Marie replied:
Sounds like a good idea for now. It may help keep him feeling more clean.
Customer reply:
Last night we started the first dose of reactine 10 mg bid, itchiness dropped by 80%. Even his chin scratching is just a few seconds. He seems much calmer but also a bit sedated.
Is the best option in the long run to go for the blood test and hypersensitizing?
A summer full of reactine could cost more plus from last year to this year the sensitivity had doubled
Dr. Marie replied:
It's a tough call Jay. As you likely know, the blood tests are not always 100% accurate. With that being said I've had some fantastic results with doing them. I had one dog whose owner cooked him steak every single night. It turned out that the test said he was allergic to beef, so they switched to cooking him chicken every night and his allergies were GREATLY improved.
If your vet is thinking it's a good idea, then I'd go for it.
Customer reply:
Tuesday I brought Max in to draw blood for the allergen test. At the same time he was started on pred, continue Reactine 10mg BID and add essential fatty acids.
On Tuesday night he had pred 1 x 10 mg.
Wed 2 x 10 mg
Thu 2 x 10 mg
(Fri will be 2 x 10 mg, Sat 1 x 10 mg, etc)
My question is...
Last night he nipped at his paws for a few seconds. Tonight he scratched his chin for a few seconds. I guess I was assuming after 4 x 10 mg doses his immune system would be zonked out enough that there would be no itchiness?
Or should I let it go until Saturday before becoming too anxious?
Dr. Marie replied:
I wouldn't be too worried about a couple of incidents. It sounds like your vet has you starting on a lower dose and then working up to see what is going to be the most effective. So, it may be that Max needs the higher dose.
Really though, my goal when I have a dog on prednisone is to have the dog comfortable for the majority of the day. If there is the occasional scratch or lick I am not worried.
Customer reply:
That's good advice. And 20 a day is the high dose. Saturday it goes down to 20 a 10mg a day then 10 every two days and hopefully 5 every two days.
Customer reply:
Dr,
If you have a moment I'd appreciate your oppinion on this.
Last summer Max was scratching from May to August even though he was on Skin Support.
Beginning 3 weeks ago, on a Thursday, he suddenly began scratching all over his body (tops of arms, tops of legs, chin, shoulder, red ear). But nothing between toes. No lesions. No redness.
His steroid treatments began Thursday, so far with great success. They are gradually lowering the dose.
The blood tests have come back with environmental reactions too low to measure!
Vet thinks it may be mould? Dust? He's not sure.
Any thoughts?
Thank you.
Jay
PS a vet friend of mine linked your "Why are vet visits so expensive" on his Facebook site.
Dr. Marie replied:
Hi Jay. I'm glad to hear that the steroids are helping Max.
I have had some dogs who are allergic to dust in the house. I had one dog that had severe respiratory allergies (i.e. sneezing.) The owner noticed that the dog always had a sneezing fit at 5:30 a.m. which was annoying because it always woke the owner up. Well, suddenly a light went off in both of our heads when he was talking about this and we both realized what was happening. The dog slept next to his bed right by the heating vent. The heat was on a timer and came on at 5:30 every morning. The guy had his ducts cleaned and the dog did dramatically better!
The thing with allergies is that it is rarely black and white. I tell my clients that allergic dogs have a threshold. If the allergy level gets above this threshold then we see symptoms. So let's say Max has a little bit of allergy to dust, and a little bit to pollen, and a little bit to some food ingredient. When the total combination of allergens gets to a certain level then we start to see itchiness. We can't always blame it on just one or two things.
Thanks for mentioning my article. In the last two days it has gone crazy on Facebook and gotten over 13,000 Facebook likes. I guess it resonates with a lot of people.
Dr. Marie.
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